Injectable Fluocinolone Implant for the Management of Chronic Postsurgical Cystoid Macular Edema in Vitrectomized Eyes.

Abstract

Long-acting injectable steroids are changing the treatment paradigm for patients with chronic intraocular inflammation and cystoid macular edema (CME). We report the use of the fluocinolone implant (FAI) 0.18 mg in patients with chronic postsurgical CME following pars plana vitrectomy (PPV). This is a retrospective case series of 24 vitrectomized eyes which received FAI for the management postsurgical CME. Clinical outcomes and requirement for rescue therapy were studied. Median length of follow-up was 19.3 months (range 8.3-23.2 months). There was an improvement in median central subfield thickness from 412 μm (range 167-806 μm) to 311 μm (range 157-686 μm) following FAI (p < 0.001). The injection burden decreased significantly following study treatment (p < 0.001); however, there was no significant change in visual acuity (p = 0.334). Eighteen eyes had control of CME that did not require additional intravitreal therapy. Four eyes had initially controlled but recurrent CME requiring intravitreal steroid therapy at median of 7.8 months (range 7.6-15.4 months). One eye never attained sufficient inflammatory control despite rescue therapy. FAI can be an effective treatment in vitrectomized patients with chronic postsurgical CME and can help decrease the overall injection burden.